Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.39 / $35.54 / $84.65	Facility		$27.39	$35.54	$84.65
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $67.00 / $74.16 / $74.16	Facility	CQ	$67.00	$74.16	$74.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $22.58 / $161.19	Professional		$15.84	$22.58	$161.19
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $12.06 / $16.85 / $24.98	Professional	CQ	$12.06	$16.85	$24.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.70 / $33.70 / $65.00	Facility		$33.70	$33.70	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.08 / $31.35 / $89.33	Professional		$25.08	$31.35	$89.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $36.38 / $60.00	Professional		$23.12	$36.38	$60.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.96 / $41.42 / $134.74	Facility		$20.96	$41.42	$134.74
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $56.39 / $114.53 / $114.53	Facility	CQ	$56.39	$114.53	$114.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $29.49 / $83.38	Professional		$23.03	$29.49	$83.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $33.70 / $44.23 / $58.90	Facility		$33.70	$44.23	$58.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $44.45 / $62.69	Professional		$33.00	$44.45	$62.69
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $334.80 / $937.44	Facility		$97.22	$334.80	$937.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $37.72 / $52.96	Professional		$27.90	$37.72	$52.96
United Facility/Professional Professional Modifier Low / Median / High Price $21.71 / $29.31 / $45.85	Professional		$21.71	$29.31	$45.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.10 / $37.10 / $43.60	Professional		$37.10	$37.10	$43.60